2020 Global Health
Impact Report

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Credit: Aaron Santelices via Unsplash

01

SECT. 1
Introduction

A decade is a powerful length of time.

It provides a natural reflecting point, both to look forward to what is to come, and to look back on what has - or has not - been achieved. The global development sector frequently uses decades as a unit of measurement: for funding envelopes, development priorities, and target setting. Perhaps this is because decades typically contain multiple political configurations, international events, and scientific discoveries that change the world. At the same time, they pass soon enough that we can imagine ourselves being a part of that change.

How are we landing here?

Entering into 2020, it was well-documented that progress in pursuit of the Sustainable Development Goals (SDGs) was already uneven at best, and significant work was needed to achieve results.

Between 2010-2020, critical gains have been made in global health and gender equality goals. The issue remains, however, that so many are still left behind:

1.1%

Women and girls of reproductive age whose need for family planning is satisfied with modern contraceptive methods increased by only 1.1% over 10 years. Today, more than 250 million women still have unmet contraceptive needs.

2.9%

The average global maternal mortality ratio declined by 2.9% each year in the last decade. This is less than half of the needed 6.4% annual rate.

2.5%

The proportion of women who were married or in union before age 15 declined by only 2.5% in the last decade. At the start of this decade, one in five women globally is married before the age of 18.

Within this context, achieving the SDGs in this Decade of Action is a challenging proposition:

One Third

According to the SDG 2020 report, approximately one third of respondents believe that poor data and statistics are the main barriers to achieving the SDGs in their country

16%

According to a UN review of countries, only 16% of respondents believed that their country was on track to achieving all or most of the SDGs

10 years

We have 10 years left to achieve the combined targets under SDG 3 and SDG 5

A new challenge for a new decade

“The pandemic has taught us once again the value of real-time information, and the enormous costs of flying blind into a storm.”

- The Sustainable Development Report

Unquestionably, the COVID-19 crisis has fundamentally transformed our daily and collective lives. Earlier this year, CanWaCH documented the immediate implications of, and response to, COVID-19 on the part of Canadian organizations. Through this investigation, we heard just how significant the challenges are when it comes to the current state of our global health information and statistical systems, many of which are already limited or weak. Though varied across different contexts, challenges include but certainly are not limited to:

  • Delays or cancellations in planned censuses, evaluations, research, and surveys - and the long-term implications of this data gap;
  • Reallocated funding away from national statistics offices, projects, and research - and the long-term implications of this lack of investment;
  • Lack of data privacy, management, and ethics protocols, capacity, or training - and the implications for individual safety and well-being.

The implication is alarming. When we do not have reliable data, we simply cannot be sure where we are and where to go next.

Transformation for Impact

COVID-19 has already changed so much of how we work, and will continue to bring change in the months, years, and decade to come. Just as achieving the SDGs requires us to be creative and flexible, COVID-19 requires us to challenge the assumptions and common ways of working that have kept us from making the progress we had hoped to see by this point. In developing this report, we heard clearly that measurement and information processes need to adapt quickly to an increasingly virtual environment.

As we are physically separated from our partners like never before, we are forced to confront tough questions about the ways in which the accountability systems we have used to date have been helpful, or limiting. The SDGs are both local and global in their application, and coordinated strategies between communities, regions, and countries will be vital. This will require us to rely on trusting, equitable relationships with local stakeholders more than ever.

“Achieving the SDGs necessitates a transformation of economies, societies and human behavior”

In this report

CanWaCH will take a close look at the global and country-specific numbers that speak to what we have collectively achieved in the past decade - and those achievements are many. We will also examine the evaluation and accountability strategies that partners are using, to understand how these processes may promote, or inhibit, our future achievements. Achieving the SDGs in this decade of action will be challenging, but we have every confidence that Canadian actors and their partners have the determination, creativity, and willingness to make this transformative approach a reality.

Notes from CanWaCH

As 2020 began, we collectively entered the ‘Decade of Action’ with a determined commitment to achieving the Sustainable Development Goals. Our 2019 Global Health Impact Report  celebrated the achievements of the previous decade by Canada’s global health leaders and their partners. There, we documented dozens of innovative, ambitious, and impactful strategies that Canadians have been a part of, and the results that this work has had on the lives of diverse women, children, youth, and their communities worldwide. Additionally, we were motivated by Canada’s historic commitment to the health and rights of women and adolescents, which builds on the previous decade’s leadership in maternal, newborn, and child health, to steer us through this new decade with the essential resources needed to make meaningful change.

Now, in the final season of 2020, the world looks very different than we expected. COVID-19 has forced all of us to re-evaluate, re-prioritize, and re-configure our operations and programming to meet a global health crisis of unprecedented scale. Just 100 days after COVID-19 was declared to be a pandemic,  CanWaCH produced a report documenting initial responses to COVID-19 with a particular focus on the role of evidence in decision-making, and the adaptation strategies that all stakeholders were undertaking. In addition, essential discussions around pervasive and systemic racism, colonialism, and inequitable power dynamics in our sector have called on all of us to assess how we actively resist oppression.

What CanWaCH has heard clearly is that in this environment of uncertainty, when a global pandemic keeps us physically distant, we must rely on each other more than ever. There is no doubt that equitable, trusting partnerships will be foundational if we are to address the challenge of COVID-19 and attempt to meet, let alone surpass, the ambitious targets of the SDGs, particularly Goal 3: Good Health & Well-Being, and Goal 5: Gender Equality, in the coming decade. Many of the thought leaders who contributed to this year’s Global Health Impact Report are among those calling for us in Canada to ‘walk the talk’ when it comes to ensuring that local voices are not simply consulted, but are the true leaders of change. As good partners, it is our responsibility to listen and act in solidarity with them. To do this effectively, we will of course need to explore new ways of connecting and working virtually, and as well as find practical strategies to gather evidence upon which we can all rely.

The insights in this report will, we hope, inspire us all to think about how we will move through the rest of this critical decade in response to the crises we face personally and globally. We can look back on our past achievements with pride. Looking forward, I hope that we will use the new and emerging tools at our disposal to partner with sincerity and humility; share information openly and ethically; and be ambitious champions for women, children, and youth everywhere.

In solidarity,

Julia Anderson,
Chief Executive Officer

02

SECT. 2
Methodology

Methodology

The data included in this report is a culmination of multiple targeted outreach efforts by CanWaCH to members and non-members. Between January and September 2020, CanWaCH conducted both general and targeted calls for data on general and specific global health interventions relating to sexual and reproductive health and rights, COVID-19 response efforts, health systems strengthening, and general activities. This was supplemented by or triangulated with online search of websites and published materials, including the Global Affairs Canada Project Browser.

Organizations1 are also able to contribute data at any time of year, via CanWaCH’s Project Explorer platform. In all cases, CanWaCH collects robust data across 17 primary data fields. Data is sourced in English and/or French, and translation is provided. For the Country Dashboard section of this report, the 5 countries were selected for inclusion based on the high overall funding value of Canadian projects implemented over the past decade. Detailed digital dashboards on these and other countries are available on our website. Unless otherwise specified, all financial figures presented in this report are in Canadian dollars. 

To offer context to the data collected, CanWaCH also conducted virtual dialogues and interviews with dozens of Canadian and global stakeholders including civil-society organizations, academic institutions, health professional associations, and others. As a result, more than 90 partners worldwide have contributed to this report through various channels. These conversations frequently included references or connections to other colleagues or literature, and we are grateful to everyone who has contributed to the insights that form the basis of this report. Please note that quotes or examples (where used) have been anonymized and are not attributed to a particular organization or individual.

With more than 1130 projects currently available for analysis as of this publication, the CanWaCH Project Explorer has more than doubled in size and power since last year’s report. Among other factors, this is due to the active participation of a sector that clearly sees the value in sharing data for collective learning and transparency. The CanWaCH Project Explorer continues to provide valuable aggregate analysis of the depth and breadth of Canada’s work in global health and gender equality since 2010, along with interactive digital interactive tools for analysis and interpretation. Detailed methodological notes on CanWaCH’s coding and data management processes are available on request. All collected data is publicly available in open-source format for download and independent analysis.

As the Project Explorer is a living tool generated with the sector from projects that are very new or have long-since closed, it contains some projects that have limited available data. It may also not include data on active projects that, for reasons of safety for participants and staff, cannot be fully disclosed publicly. Wherever relevant, sample sizes are noted. While numbers are accurate at the time of publication, please visit the website for the most recent figures. As always, we are particularly grateful to the CanWaCH Metrics Working Group for the ongoing advice, insight, and feedback that has shaped this report and our analyses this year.

1CanWaCH categorizes organizations using the IATI Standards Organization Type definition along with the country of registration. For the purpose of aggregating data from similar organization types, the Project Explorer categorizes organization types as follows: 1. NGO: i) contains IATI categories including National NGO, International NGO, Regional NGO, or Foundation & ii) will be assigned as a Canadian-based NGO if the country of registration is Canada; 2. Academia and Research: i) contains IATI category: Academic, Training and Research & ii) will be assigned as a Canadian-based Academia and Research institution if the country of registration is Canada; 3. Private Sector: i) contains IATI category: Private Sector & ii) will be assigned as a Canadian-based Private Sector organization if the country of registration is Canada; 4. Multilateral: contains IATI category: Multilateral; 5. Government & Public Sector: i) contains IATI categories: Government or Other Public Sector & ii) will be assigned as Canadian for Government of Canada entities.

Project Explorer

Credit: Kevin Gitonga for Amref Health

03

SECT. 3
Project Explorer

The data included in the following section is sourced from the CanWaCH Project Explorer, a digital tool which endeavours to capture the full spectrum of Canadian activities in global health and gender equality.

This includes data on activities that are funded by the Government of Canada, as well as by other funding sources. The Project Explorer includes detailed project level data, maps, and aggregate analyses, with the aim of helping users to ultimately share, learn, work, and partner more effectively.

CanWaCH’s Project Explorer houses detailed project-level data on:

1105

global development and humanitarian initiatives

154 countries

most of which were operational or launched between 2010-2020

$14,760,313,165

of combined funding value
(in Canadian dollars)

Canadian Projects Around the World

Between 2010-2020, the following countries received the highest overall amount of funding from the reported projects:

Top 10 Countries by Total Value of Reported Projects2

Country silhouette of Mozambique

01

Tanzania

$765,515,088

Country border silhouette of Mozambique

02

ethiopia

$704,142,740

Country silhouette of Mozambique

03

Afghanistan

$623,090,607

Country silhouette of Mozambique

04

Mali

$577,464,505

Country silhouette of Mozambique

05

Haiti

$569,886,215

Country silhouette of Mozambique

06

Mozambique

$559,758,935

Country silhouette of Mozambique

07

Bangladesh

$544,500,645

Country silhouette of Mozambique

08

South Sudan

$470,068,657

Country silhouette of Mozambique

09

Ghana

$467,035,891

Country silhouette of Mozambique

10

Nigeria

$325,498,454

Detailed dashboards on specific countries are available on our website, as well as in a later section of this report.

The CanWaCH Analytics Portal interactive map illustrates the total number of all global projects per country, as well as their combined budgets.

Investments may also be viewed by region. Between 2010-2020, countries in Sub-Saharan Africa represented the most frequently reported countries of work (54.6%), followed by South Asian nations (13.9%).

2 Sample size (September 2020): 1061 projects.

Global Health Priority Issues

In terms of focus priorities3 in global health between 2010-2020, the overall top five by fund allocation were:

3Sample size (September 2020): 722 projects

Communities and Populations

1,970,456,760 people

CAD $4,899,362,964

93 Countries

While disaggregated population data is not always available for all projects during the last decade, a subset of Project Explorer projects with detailed population data reported reaching or planning to reach a combined total of 1,970,456,760 people of all ages and genders4 across 93 countries. The combined value of these initiatives was CAD $4,899,362,264 or approximately CAD $2.49/person.

89% Adult Women (18+)
64% Adolescent Girls
50% Girls Over 5
59% Adult Men (18+)
47% Adolescent Boys
46% Boys Over 5
21%

Senior Men

22%

Senior Women

54% Children Under 5

Those projects demonstrate that a wide range of population groups are being reached in a variety of settings.

Age and Gender Data5  

Communities and Groups6

Note: No disaggregated population data was provided by contributors on work with gender diverse communities, although contributors are able to select identities other than ‘female’ or ‘male’ when adding data. We recognize that this may be for many reasons, and certainly does not reflect the realities of communities or the work of projects. Significant additional work is needed to understand the realities, risks, and opportunities of collecting and reporting this data accurately, and working with people in all their diverse identities.

4Direct population sample size: 483 projects with a total reach of 1,781,363,637 people. Indirect population sample size: 138 projects with a total reach of  189,093,123 people. Please note: projects include information on population reached (achieved or expected), including the direct population served as well as the indirect population reached if applicable. The figures given here reflect the sum of all numbers available in the Project Explorer, irrespective of project budget, area of focus, and population details. The population dataset contains a wide range of figures (779 million people [largest] to 5 people [smallest] as of this report). Similarly, the range of project budgets with available population information varies from $165,000,000 (maximum) to $12,149 (minimum).
5 Sample size with target population age and gender data reported: 472 projects
6 Sample size with target population descriptors: 246 projects


Measuring Results

CanWaCH collects information from reporting organizations on select SDG 3 and SDG 5 indicators they are using to track project progress. A subset of projects implemented by civil society organizations which reported measuring at least one SDG 3 or 5 indicator7 were analyzed:

91%

of reported projects used at least one SDG 3 indicator

52%

3.1.2 Proportion of births attended by
skilled health personnel

33%

3.2.2 Neonatal mortality rate

48%

3.1.1 Maternal Mortality Ratio

33%

3.7.1 Proportion of women of reproductive age (aged 15-49 years) who have their need for family planning satisfied with modern methods

31%

3.2.1 Under-5 mortality rate

11%

5.2.2 Proportion of women and girls aged 15 years and older subjected to sexual violence by persons other than an intimate partner in the previous 12 months, by age and place of occurrence

22%

of reported projects used at least one SDG 5 indicator

7 Sample size (September 2020): 64 projects

Credit: Hanson Lu via Unsplash

04

SECT. 4
COUNTRY DASHBOARD

The Project Explorer contains over 1130 global health and development projects implemented since 2010 and spanning work in 154+ countries. Earlier in this report, we examined the top 10 countries where cumulative Canadian funding and efforts have been greatest. In order to offer a more in-depth look at how Canada is engaging in these countries, CanWaCH has also developed robust digital Country Snapshots, with details available by year and interactive maps and data visualizations of funding, populations reached, activities, and more.

For this report, we are providing five detailed Country Dashboards. The selected countries - Afghanistan, Bangladesh, Ethiopia, Mozambique, and Tanzania - represent five of the top 10 countries of investment. These dashboards showcase a decade of Canadian engagement at a glance; examining how and with whom Canadian organizations are working. In addition, these countries are among those where CanWaCH engages most actively through our Country Working Groups and Canadian Collaborative for Global Health projects. Click through the spotlights below to learn more about the work of these initiatives over the past year.

The data in this section of the report should not be taken as official, and represents only the sample of projects available in the Project Explorer. Therefore, these numbers should be viewed as interesting insights, but should not be considered a final, comprehensive or accurate summary or commentary on any of Canada’s official commitments. 

Afghanistan Country Dashboard: 2010-Present

View Detailed Project Map Here

64

Total Number of Projects7

$623,090,607

Combined Funding Value8

7Includes development and humanitarian projects
8All funds in dashboard are in CAD $

Projects Timeline

Total Number of Projects & Funding by Year

Reporting Organizations by Funding (all years):

Areas of Focus by Funding (Health only)

Population Reach

COVID-19 Highlights
View all COVID-19 projects here

Reporting/Lead Organizations Receiving Funds

NGOs Total

$222,659,298

Funding: 35.7 %

NGOs - Canadian Based

Total funds

$ 189,908,242

Funding %

30.5 %

NGOs - Other Countries

Total funds

$ 32,751,057

Funding %

5.3 %

Academia & Research Total

---

Funding: ----%

Academia & Research Canadian Based

Total funds

---

Funding %

---

Academia & Research Other Countries

Total funds

---

Funding %

---

Private Sector Total

$8,589,986

Funding: 1.38 %

Private Sector
Canadian Based

Total funds

$ 2,850,000

Funding %

0.5 %

Private Sector
Other Countries

Total funds

---

Funding %

---

Multilateral

$388,498,483

Funding: 62.4 %

Government & Public Sector

$3,342,840

Funding: 0.5 %

Government & Public Sector - Canada

Total Funds

$ 3,342,840

Funding %

0.5 %

Government & Public Sector - Other Countries

Total Funds

---

Funding %

---

Total

$623,090,607

Government of Canada Funding Initiatives10

NGO’s Canadian Based

MNCH 
2015-202012

Total Funds

$ 12,549,870

# of Projects

2

SRHR
2017-202013

Total Funds

---

# of Projects

0

MNCH
2010-201511

Total Funds

$ 122,265,173

# of Projects

12



10 These analyses are based on publicly available information and/or information provided directly by Reporting Organizations as of the publication of this report, and may not be complete. These numbers should be viewed as interesting insights, but should not be considered a final, comprehensive or accurate summary or commentary on any of Canada’s official commitments.
11,Government of Canada’s Muskoka Commitment 2010-2015, according to publicly available information. Please note that the list of projects may not be exhaustive.
12 Government of Canada’s Muskoka Commitment 2015-2020, according to publicly available information. Please note that the list of projects may not be exhaustive.
13 Government of Canada’s Sexual and Reproductive Health and Rights Commitment 2017-2020, according to publicly available information. Please note that the list of projects may not be exhaustive.1
1

Bangladesh Country Dashboard: 2010-Present

View Detailed Project Map Here

79

Total Number of Projects14

$543,828,716

Combined Funding Value of
Total Projects15

14Includes development and humanitarian projects
15All funds in dashboard are in CAD $

Projects Timeline

Total Number of Projects & Funding by Year

Reporting Organizations by Funding (all years):

Areas of Focus by Funding (Health only)

Population Reach

COVID-19 Map of Bangladesh
View all COVID-19 projects here

Reporting/Lead Organizations Receiving Funds

NGOs Total

$158,803,348

Funding: 29.2%

NGOs - Canadian Based

Total Funds

 $ 140,556,134

Funding %

25.8 %

NGOs - Other Countries

Total Funds

$ 18,247,214

Funding %

3.4 %

Academia & Research Total

$64,441,249

Funding: 11.8%

Academia & Research Canadian Based

Total Funds

$ 7,245,984

Funding %

1.3 %

Academia & Research Other Countries

Total Funds

 $ 57,195,265

Funding %

10.5 %

Private Sector Total

$19,700,000

Funding: 3.6%

Private Sector
Canadian Based

Total Funds

$ 19,700,000

Funding %

3.6 %

Private Sector
Other Countries

Total funds

---

Funding %

---

Multilateral

$300,689,023

Funding: 55.3%

Government & Public Sector

$195,097

Funding: 0.04% 

Government & Public Sector Canada

Total Funds

$ 195,097

Funding %

0.04 %

Government & Public Sector Other Countries

Total Funds

---

Funding %

---

Total

 $543,828,716

Government of Canada Funding Initiatives16

NGO’s Canadian Based

MNCH 
2015-202018

Total Funds

$25,347,198

# of Projects

2

SRHR
2017-202019

Total Funds

$77,956,671

# of Projects

12

MNCH
2010-2015
17

Total Funds

$35,541,228

# of Projects

9



16These analyses are based on publicly available information and/or information provided directly by Reporting Organizations as of the publication of this report, and may not be complete. These numbers should be viewed as interesting insights, but should not be considered a final, comprehensive or accurate summary or commentary on any of Canada’s official commitments.
17Government of Canada’s Muskoka Commitment 2010-2015, according to publicly available information. Please note that the list of projects may not be exhaustive.
18 Government of Canada’s Muskoka Commitment 2015-2020, according to publicly available information. Please note that the list of projects may not be exhaustive.
19 Government of Canada’s Sexual and Reproductive Health and Rights Commitment 2017-2020, according to publicly available information. Please note that the list of projects may not be exhaustive.1
1

Ethiopia Country Dashboard: 2010-Present

View Detailed Project Map Here

91

Total Number of Projects20

$704,142,740

Combined Funding Value of
Total Projects21

20Includes development and humanitarian projects
21All funds in dashboard are in CAD $

Projects Timeline

Total Number of Projects & Funding by Year

Reporting Organizations by Funding (all years):

Areas of Focus by Funding (Health only)

Population Reach

COVID-19 map of Ethiopia
View all COVID-19 projects here

Reporting/Lead Organizations Receiving Funds

NGOs Total

$201,733,925

Funding: 28.6%

NGOs - Canadian Based

Total Funds

$ 190,615,621

Funding %

27.1 %

NGOs - Other Countries

Total Funds

$ 11,118,304

Funding %

1.6 %

Academia & Research Total

$ 17,952,374

Funding: 2.5%

Academia & Research Canadian Based

Total Funds

$ 4,643,096

Funding %

0.7 % 

Academia & Research
Other Countries

Total Funds

$ 13,309,278

Funding %

1.9 %

Private Sector Total

$16,307,258

Funding: 2.3%

Private Sector
Canadian Based

Total Funds

$ 16,307,258

Funding %

2.3 %

Private Sector
Other Countries

Total funds

---

Funding %

---

Multilateral

$ 457,562,197

Funding: 65%

Government & Public Sector

$ 10,586,986

Funding: 1.5%

Government & Public Sector Canadian Based

Total Funds

$ 10,586,986

Funding %

1.5 %

Government & Public Sector Other Countries

Total Funds

---

Funding %

---

Total

$704,142,740

Government of Canada Funding Initiatives22

NGO’s Canadian Based

MNCH 
2015-202024

Total Funds

$14,089,237 

# of Projects

2

SRHR
2017-202025

Total Funds

$41,781,841 

# of Projects

4

MNCH
2010-2015
23

Total Funds

$112,617,467 

# of Projects

12



22 These analyses are based on publicly available information and/or information provided directly by Reporting Organizations as of the publication of this report, and may not be complete. These numbers should be viewed as interesting insights, but should not be considered a final, comprehensive or accurate summary or commentary on any of Canada’s official commitments.
23,Government of Canada’s Muskoka Commitment 2010-2015, according to publicly available information. Please note that the list of projects may not be exhaustive.
24Government of Canada’s Muskoka Commitment 2015-2020, according to publicly available information. Please note that the list of projects may not be exhaustive.
25Government of Canada’s Sexual and Reproductive Health and Rights Commitment 2017-2020, according to publicly available information. Please note that the list of projects may not be exhaustive.1
1

Mozambique Country Dashboard: 2010-Present

View Detailed Project Map Here

68

Total Number of Projects26

$556,226,320

Combined Funding Value of
Total Projects27

26Includes development and humanitarian projects
27All funds in dashboard are in CAD $

Projects Timeline

Total Number of Projects & Funding by Year

Reporting Organizations by Funding (all years):

Areas of Focus by Funding (Health only)

Population Reach

COVID-19 map of Mozambique
View all COVID-19 projects here

Reporting/Lead Organizations Receiving Funds

NGOs Total

$ 154,981,093 

Funding: 27.9%

NGOs - Canadian Based

Total Funds

$ 118,104,569

Funding %

21.2 %

NGOs - Other Countries

Total Funds

$ 36,876,524

Funding %

6.6 %

Academia & Research Total

$38,799,500 

Funding: 7%

Academia & Research Canadian Based

Total Funds

$ 30,674,500

Funding %

5.5 %

Academia & Research
Other Countries

Total Funds

$ 8,125,000

Funding %

1.5 %

Private Sector Total

---

Funding: --

Private Sector
Canadian Based

Total Funds

---

Funding %

---

Private Sector
‍Other Countries

Total Funds

---

Funding %

---

Multilateral

$208,971,727

Funding: 37.6%

Government & Public Sector

$153,474,000

Funding: 27.6%

Government & Public Sector
Canada

Total Funds

$ 3,474,000

Funding %

0.6 %

Government & Public Sector
Other Countries

Total Funds

$ 150,000,000

Funding %

27 %

Total

$556,226,320

Government of Canada Funding Initiatives28

NGO’s Canadian Based

MNCH 
2015-202030

Total Funds

$ 19,688,514

# of Projects

3

SRHR
2017-202031

Total Funds

$ 166,271,791

# of Projects

10

MNCH
2010-2015
29

Total Funds

$ 172,928,723

# of Projects

11



28 These analyses are based on publicly available information and/or information provided directly by Reporting Organizations as of the publication of this report, and may not be complete. These numbers should be viewed as interesting insights, but should not be considered a final, comprehensive or accurate summary or commentary on any of Canada’s official commitments.
29 ,Government of Canada’s Muskoka Commitment 2010-2015, according to publicly available information. Please note that the list of projects may not be exhaustive.
30 Government of Canada’s Muskoka Commitment 2015-2020, according to publicly available information. Please note that the list of projects may not be exhaustive.
31 Government of Canada’s Sexual and Reproductive Health and Rights Commitment 2017-2020, according to publicly available information. Please note that the list of projects may not be exhaustive.1
1

Tanzania Country Dashboard: 2010-Present

View Detailed Project Map Here

113

Total Number of Projects32

$756,515,088

Combined Funding Value of
Total Projects33

32Includes development and humanitarian projects
33All funds in dashboard are in CAD $

Projects Timeline

Total Number of Projects & Funding by Year

Reporting Organizations by Funding (all years):

Areas of Focus by Funding (Health only)

Population Reach

COVID-19 map of Tanzania
View all COVID-19 projects here

Reporting/Lead Organizations Receiving Funds

NGOs Total

$254,782,404

Funding: 33.7%

NGOs - Canadian Based

Total Funds

$ 190,281,162

Funding %

25.2 %

NGOs - Other Countries

Total Funds

$ 64,501,242

Funding %

8.5 %

Academia & Research Total

$24,883,790

Funding: 3.3%

Academia & Research Canadian Based

Total Funds

$ 12,258,790

Funding %

1.6 %

Academia & Research
Other Countries

Total Funds

$ 12,625,000

Funding %

1.7 %

Private Sector Total

$7,950,034

Funding: 1.1%

Private Sector
Canadian Based

Total funds

---

Funding %

---

Private Sector
Other Countries

Total Funds

1.1

Funding %

$ 7,950,034

Multilateral

$141,732,145

Funding: 18.7%

Government & Public Sector

$327,166,715

Funding: 43.2%

Government & Public Sector Canadian Based

Total funds

---

Funding %

---

Government & Public Sector Other Countries

Total Funds

$ 308,007,225

Funding %

40.7%

Total

$756,515,088

Government of Canada Funding Initiatives34

NGO’s Canadian Based

MNCH
2015-2020
36

Total Funds

$ 39,136,892

# of Projects

5

SRHR
2017-2020
37

Total Funds

$ 15,500,000

# of Projects

1

MNCH 
2010-201535

Total Funds

$ 185,870,340

# of Projects

15



34 These analyses are based on publicly available information and/or information provided directly by Reporting Organizations as of the publication of this report, and may not be complete. These numbers should be viewed as interesting insights, but should not be considered a final, comprehensive or accurate summary or commentary on any of Canada’s official commitments.
35Government of Canada’s Muskoka Commitment 2010-2015, according to publicly available information. Please note that the list of projects may not be exhaustive.
36 Government of Canada’s Muskoka Commitment 2015-2020, according to publicly available information. Please note that the list of projects may not be exhaustive.
37 Government of Canada’s Sexual and Reproductive Health and Rights Commitment 2017-2020, according to publicly available information. Please note that the list of projects may not be exhaustive.1
1

Credit: Nowshad Arefin via Unsplash

05

SECT. 5
Reflection: 2010-2020

The past decade marked a transition from the Millennium Development Goals to the Sustainable Development Goals (SDGs), and with it, a transition towards an increasingly participatory, comprehensive set of objectives and indicators which apply to every country, everywhere. The creation of the SDGs signalled a strengthened development agenda that emphasizes the interconnected nature of the environment and human rights in achieving and sustaining development for all. This past decade also marked the launch of Canada’s Feminist International Assistance Policy (FIAP), which recognizes the importance of gender equality and the empowerment of women and girls in achieving development goals. The FIAP highlights multi-faceted action areas in support of the SDGs, and emphasizes the importance of measuring progress to ensure Canada’s feminist approach is a reality.

Many of the Canadian projects analyzed for this report that were implemented in 2015 and beyond are guided specifically by the objectives of SDG 3: Good Health and Well-being and SDG 5: Gender Equality: namely, to ensure healthy lives and promote wellbeing for all at all ages, and to achieve gender equality and empower women and girls.

Five Key Takeaways

From our analysis, it is evident that a wide variety of actors - from Canadian civil society organizations, to global and national partners and multilateral organizations, and more - are actively committed to advancing this agenda.
Below, we highlight some additional insights gleaned from Project Explorer as we reflect on the work of the last decade, particularly with regard to the impacts on health and gender equality.

1. At the start of this new decade, there is active Canadian engagement aligned with SDGs 3 and 5: Our data suggests that extensive activities have been undertaken around the world by Canadian projects implemented by organizations of all types in alignment with the current goals of SDG 3 and 5. That said, additional data is needed to fully understand Canadian engagement and/or potential gaps in traditionally neglected or under-addressed areas of development, such as sensitive topics in sexual and reproductive health and rights (SRHR), neglected tropical diseases, mental health, environmental health, and others.
2. Partnership and collaboration have been central to delivery of Canadian programming: From the available data, Canadian projects involve partners of all types, with non-Canadian civil society organizations and academic institutions (international, regional and local), and government partners being the most commonly reported. Comprehensive reporting of all partners of all types would assist with more robust analysis, although there are recognized barriers to reporting this data in certain contexts. 
3. Data remains limited on work with typically underserved populations: Data on too-frequently neglected or underserved populations is limited in the Project Explorer. It is therefore not possible to draw firm conclusions on the basis of these incomplete dataset. Additional efforts may be needed to either include vulnerable groups in programming more effectively, or to capture and report this data. Where it is safe and feasible to do so, more data is needed to understand the gaps and identify where further investments and programming are warranted.
4. COVID-19 poses the potential for significant risk to attaining SDGs 3 and 5 in the decade to come: Data collected from Canadian partners suggests that the short-term impacts of the COVID-19 pandemic have the potential to influence development practice in the medium-to-long term. Beyond immediate public health effects, many contexts are experiencing ‘domino’ challenges. Additional funds are needed to tackle COVID-19 without compromising the ongoing and upcoming Canadian investments and priority areas linked to SDG 3 and SDG 5.
5. Barriers to transparent data sharing should be explored and addressed where feasible: Through consultations with members and sector partners in 2020, CanWaCH has identified several common and persistent barriers which keep Canadian development actors and their global partners from sharing data in a confident and transparent manner. To make meaningful progress towards SDG 3 and SDG 5, capacity, resourcing and demand must be strengthened to foster Canada’s leadership in innovative, transparent and evidence-based development.
Image courtesy of ADRA Canada

Global Health Areas of Focus

Looking at reported project focus across the past decade from all reported funding sources and investment envelopes, we identified the following top six global health areas of focus by funding over the past decade:

These rankings reflect the cumulative focus areas throughout the decade. However, within specific time periods in the past decade, additional areas of focus were more dominant. For example, between 2015-2020, Newborn and Child Health was among the top three reported areas of focus among projects funded under Canada’s Muskoka 2 (MNCH2) initiative (which included a strong focus on newborn and child health and built on a similar focus in the MNCH1 commitment of 2010-2015).

Based on the above global health priority trends and the five most commonly reported SDG 3 indicators from the analyzed projects, data further suggests an alignment between the work of Canadian organizations and SDG 3 priorities. The subject areas covered in the analyzed projects align with about half of the SDG 3 targets; more specifically:

From the available data in the Project Explorer, the health-related areas of focus the least addressed between 2010-2020 include:

Going forward, it will be important to investigate if there are projects to be added that address those areas and to understand how these important areas of global health are being tackled. 

Additionally, while significant progress has been made to address SRHR through recent funding commitments and global leadership, limited public data is currently available on the degree to which commonly neglected areas of SRHR are being specifically addressed in programming. These areas include safe and legal abortion care, support for SRHR-related advocacy, SBGV, comprehensive sexuality education and comprehensive contraceptive care. Across all areas, programming that serves the SRHR needs of adolescents is also a priority.

Data gathered by CanWaCH from a sample of civil society organizations and their partners clearly showed that work is being undertaken in these areas, although at present, global coding standards do not enable easy disaggregation of data by programming areas. This will be an important area for review in the coming decade.

Intersections with Global Health: Cross-Cutting Thematic Areas

The CanWaCH Project Explorer not only showcases data related to health, but also includes data on cross-cutting themes related to the SDGs and Canada’s FIAP, such as gender equality, environment and climate change, and human rights. To date, the Project Explorer has prioritized gathering and analysis of data from projects with a strong focus on health given the priorities of Canadian sector over the last decade, particularly with the implementation of Canada’s MNCH1 (2010-2015), MNCH2 (2015-2020) and the SRHR commitments (2017-2020). When the top 10 areas of investments shown in the Project Explorer were analyzed for each of those funding initiatives, results showed that Gender Equality was reported to be among the top 10 areas of focus for the Muskoka 2 and SRHR initiatives.

This may be indicative of an increased focus on gender equality within the projects broadly, but perhaps more likely it reflects a shift in language which calls out work in gender equality as a result of the FIAP, alongside a re-orienting of project budgets to resource activities specifically related to gender equality. Going forward, it will be important to understand the extent to which cross-cutting themes like gender equality, the environment and climate change and human rights are being addressed in Canadian projects - the latter two of which have limited data published in the Project Explorer at present.

Partnerships and Collaboration

Sustainable development objectives are unlikely to be met without the engagement and leadership of diverse non-Canadian partners of various types from the countries or regions of implementation. In fact, an estimated 65% of the SDG targets will not be reached without engaging and coordinating with local, provincial and regional governments specifically. Some governments, including the Government of Canada, publish national data on SDG progress (see the Sustainable Development Goals Data Hub), but this is not the case for all countries.

Among the five selected countries analyzed in the present country dashboards, a clear pattern among the partner organizations emerged.  On average, 60% of all reported partners were non-Canadian, with the majority of them being national or regional civil society organizations and academic institutions. In certain countries, local governments also emerged as common partners. For example, in the Mozambique Country Dashboard analysis on partners, there were nearly as many local government partners (including ministries) as there were non-Canadian NGOs (including international, national and regional). This suggests that efforts are being made by the Canadian projects analyzed in engaging with a diverse range of partners in the countries of implementation, including governments.

One of the aims of the Project Explorer is to connect Canadian organizations and institutions with global and local partners in order to enhance collaboration and provide opportunities for improved partnership, transparency and coordination. Comprehensive reporting of all partners of all types should be prioritized and would assist with more robust analysis, although there are recognized barriers to reporting this data in certain contexts.

Populations Reached

Individuals
The CanWaCH Project Explorer collects data on population groups being served using standard age and sex categories. Analysis of the available data from 2010-2020 indicates that many Canadian projects targeted children under five years (54%). Additionally, the vast majority of projects targeted adult women (88%), while many reached adolescent girls (64%) and girls over five years (50%). Older adult women were included the least (21%). As for male populations, many projects targeted adult men (59%), adolescent boys (47%) and boys over five years (46%). Similarly to older adult women, older adult men were included the least (21%). These population age groups are in line with SDG 3 aiming to target all ages (ensure healthy lives and promote wellbeing for all at all ages) and SDG 5, with a strong focus on women and girls (achieve gender equality and empower all women and girls).

The Project Explorer’s detailed sex and age disaggregated data is displayed in aggregate in our online visuals. However, we face a challenge in aggregating data from multiple projects, as many use different descriptors for the populations targeted as well as different age ranges. For example, a project which references ‘women of reproductive age’ may include adolescents and adults; projects engaging ‘youth’ may differ depending on the definition of youth in a given country (as low as age 10; as high as age 30+). In addition to collecting this data, consideration is needed to find the best ways to collect and report sex and age data in straightforward but useful ways. 

One final note: the CanWaCH Project Explorer provides space for organizations to report sex and gender data; yet to date, nearly all projects report using the binary of woman/man or male/female. Looking ahead, a greater understanding of the nuances of collecting data that reflects the diversity of genders and identities of the individuals with whom we work will be essential.

Communities and Groups
Beyond individuals reached, the Project Explorer collects data on the local context and other descriptors of population groups in order to better understand and capture the intersecting identities and experiences of communities which may not always be visible through other data. Currently, data is collected on geography (rural, urban) and other identifiers (internally displaced people, refugees, persons with disabilities, local minority groups, LGBTQ2I+ communities and indigenous peoples). Analysis of the available data shows that Canadian projects reached or are planning to reach (where not yet completed) varied communities and groups within these allocations:


This categorization of data is not available for all projects in the Project Explorer and therefore, it is not possible to draw firm conclusions given the incomplete datasets. Nevertheless, there is a clear need for further data on these or other groups to be shared openly, where it is safe and feasible to do so without risking the well-being of these frequently marginalized or stigmatized groups.

COVID-19 Impact and Response

Within the first 100 days of the pandemic’s progression, many Canadian actors surveyed by CanWaCH had already pivoted development activities and re-shuffled resources to tackle the negative consequences on the health and wellbeing of populations globally. At the close of 2020, and with no immediate end to the pandemic in view, the many gains made over the past decade in some contexts may be negatively affected or reversed. Beyond immediate public health effects, global health and development practitioners are reporting ‘domino’ challenges, including rising poverty and sexual and gender-based violence (SGBV) rates, food insecurity, increased transmission of other infectious diseases (such as measles), public health security challenges and governance issues in-country. While resources are being actively mobilized as of the writing of this report, it will be some time before we understand the scale and scope of impact. Undoubtedly, data on the impacts of COVID-19, and not just the disease itself, will be needed: for instance, data on the effects of social distancing in countries with no social safety nets, or where other infectious diseases and outbreaks are more prevalent.

The past decade demonstrated Canada’s global leadership in championing the health and rights of women, adolescents, children, and their communities. Through a decade of official development commitments, alongside many other initiatives and humanitarian response efforts, the Government of Canada impacted the lives of millions of people through civil society, academia, bilateral, multilateral, and other partnerships. Official data and evaluation reports are available to document the scale and impact of this work, with others forthcoming. However, through the Project Explorer, we endeavour to complement this information with additional insights sourced from partners themselves where available. 

Note: 
The data in this section of the report should not be taken as official, and represents only the sample of projects available in the Project Explorer. We acknowledge that many of these projects are ongoing and/or have been modified as a result of COVID-19. Therefore, these numbers should be viewed as interesting insights, but should not be considered a final, comprehensive or accurate summary or commentary on any of Canada’s official commitments. 

Muskoka 1 (MNCH1) Investment: 2010-2015

View Detailed Map Here

97

Projects Available for Analysis

133

Countries

Canadian Partners

13.9%

Non-Canadian Partners

3.2%

Multilateral Agencies

73.2%

Bilateral

9.7%

Top 10 Countries38

Tanzania

Mozambique

South Sudan

Afghanistan

Mali

Ethiopia

Haiti

Nigeria

Bangladesh

Malawi

Top 10 Areas of Focus

Sexual Health & Rights

Infectious &
Communicable Diseases

Health Systems, Training & Infrastructure

Nutrition

Primary Health Care

Reproductive Health & Rights incl. Maternal Health

Law, Governance & Public Policy

Health Promotion

WASH

Food Security

38 Note that an additional $714,000,000 in funds is assigned to regions rather than specific countries.

Populations Reached

120,918,228 people

27 Countries

Total number of projects available for population analysis: 68

Those projects demonstrate that a wide range of population groups are being reached in a variety of settings.

Direct population reach: 120,918,228 people of all ages and genders across 27 countries

Age and Gender Data

Sub-Analysis: Communities and Groups

39 Subset reflects those projects with available descriptors. Sample size for sub-analysis: 45 projects

Muskoka 2 (MNCH2) Investment: 2015-2020

View Detailed Map Here

36

Projects Available for Analysis

31

Countries

Canadian CSOs

86.9%

Canadian Academic Institutions

6.8%

Canadian Private Sector

6.3%

Top 10 Countries

Haiti

Malawi

Tanzania

Guatemala

Kenya

Mali

Bangladesh

Ghana

Congo (DRC)

Mozambique

Top 10 Areas of Focus

Reproductive Health & Rights incl. Maternal Health

Primary Health Care

Newborn & Child Health

Nutrition

Health Systems, Training & Infrastructure

Health Promotion & Education

WASH

Gender Equality

Sexual Health & Rights

Law, Governance & Public Policy

Populations Reached

18,096,483 people

30 Countries

Total number of projects available for population analysis: 34

Those projects demonstrate that a wide range of population groups are being reached in a variety of settings.

Direct population reach: 120,918,228 people of all ages and genders across 27 countries

Age and Gender Data

Sub-Analysis: Communities and Groups40

40 Subset reflects those projects with available descriptors. Sample size for sub-analysis: 30 projects

SRHR Investment: 2017-2020

View Detailed Map Here

109

Projects Available for Analysis

47

Countries

Canadian Partners

16%


Non-Canadian Partners

19.4%


Multilateral

44.2%


Bilateral

4.7%


Non-Identified

15.7%

Top 10 Countries41

Mozambique

Bangladesh

Burkina Faso

Congo (DRC)

Nigeria

Iraq

Syrian Arab Republic

Ethiopia

Haiti

Lebanon

Top 10 Areas of Focus

Reproductive Health & Rights incl. Maternal Health

Humanitarian Response

Law, Governance & Public Policy

Sexual & Gender-based Violence

Health Systems, Training & Infrastructure

Education

Sexual Health & Rights

Human Rights, Advocacy & Public Engagement

Gender Equality

41 Note that an additional $66,596,451 in funds is assigned to Regions rather than specific countries.

Population Reached

15,546,752 people

33 Countries

Total number of projects available for population analysis: 66

Those projects demonstrate that a wide range of population groups are being reached in a variety of settings.

Direct population reach: 15,546,752 people  of all ages and genders across 33 countries

Age and Gender Data

Sub-Analysis: Communities and Groups42

42 Subset reflects those projects with available descriptors. Sample size for sub-analysis: 41 projects

Strengthen

During conversations with members and sector practitioners, investments in health systems strengthening (HSS) was identified as a vitally important component of COVID-19 efforts. Specifically, it was noted that it is hard to plan an adequate response when the health systems infrastructure is weak, and information systems are unreliable or unavailable.

Historically, HSS has been a significant focus for Canada’s investment in global health, as is demonstrated by the analyzed data in this report. Despite this, tracking progress in HSS continues to be a challenge. The ability to track, aggregate and analyze HSS efforts through clear measurement frameworks is paramount for achieving not only short term goals, such as responding to the COVID-19 pandemic, but also for transforming global health programming and meeting the SDGs. However, robust tracking of HSS at the project-level has been complicated by its broad definition within the sector.

Beyond further investments, what is especially needed is improved reporting and measures to track healthcare system preparedness, prevention programs and pandemic resilience. Going forward, Canadian development actors should re-examine existing global frameworks and standards to ensure that they reflect current technology and contextual realities.

Respond

Strengthening data and evidence, monitoring progress, and reinforcing the link between evaluation and the SDGs are key accelerators to achieving the SDGs by 2030. In addition, stronger data systems will help ensure a COVID-19 response and recovery that is based on evidence.  Within the COVID-19 context, sector-identified priorities include:

Share

CanWaCH encourages all organizations in the sector to share data, resources, and learning in a transparent manner when it is safe and appropriate. We believe that doing so is a critical step in modelling a feminist approach to data by encouraging mutual accountability and shared decision-making power along with a commitment to iterative learning. At the same time, we recognize that there are many reasons why organizations may not share their data. Through capacity-building sessions and consultations, CanWaCH identified multiple barriers experienced by Canadian organizations with regard to sharing their data, including but not limited to:

Looking forward, strategies to address these barriers and challenges will need to be examined, and organizations of diverse sizes may need resourcing and training to navigate the challenges of transparent data sharing effectively.

Innovate

The COVID-19 pandemic has underscored that creative, unorthodox thinking is needed not just in program design, but also in the design of monitoring, evaluation, accountability, and learning (MEAL) systems. Virtual methodologies, data modelling, secondary data analysis, and increased inclusion of qualitative methods are only some examples of practices that are increasingly becoming part of standard practice for many organizations.

As part of a commitment to fostering an innovative and creative mindset when it comes to data and MEAL, CanWaCH launched the inaugural Canadian Collaborative for Global Health between 2018-2020. This initiative brings together Canadian and global partners to solve urgent data challenges in global health and gender equality. Rooted in a feminist approach, the ultimate goal is to create lasting change and contribute meaningful progress towards the SDGs. Final results and reports from the first initiative will be available in early 2021. 

Canadian Collaborative for Global Health: At A Glance

6 Lab projects were operational between approximately September 2018-November 2020 

Projects are co-led by 13 Canadian organizations and institutions, and 19 global partners

Canadian Partners

Other Partners

Projects are active in 26 countries

Top six countries by budget allocation: Ethiopia, Vietnam, Senegal, Tanzania, Somalia, and Afghanistan

100% of projects are reaching both adult women and adult men (18+ years) through their work. In addition, projects are also reaching:

Source: Annie Spratt via Unsplash

06

SECT. 6
Action: 2020 & beyond

The COVID-19 pandemic has reinforced the unpredictable nature of global events, and underscored the interconnectedness of countries and communities. How can we use the data and information systems that we have refined over the last decade in the face of this uncertain future? Is attainment of the SDGs even possible?

As CanWaCH contemplated the focus of this ‘future considerations’ portion of our report, we reviewed the insights gleaned from the 100 Days of a Pandemic report, minutes from dozens of working group and other sector consultation meetings, Project Explorer data, sector literature, and more. We searched for any common themes where COVID-19 had triggered new reflections and considerations and, interestingly, a central topic emerged clearly. A priority concern and question for our changing sector in the year to come is the challenge, duty, and goal of localization.

Methodology

CanWaCH conducted open-ended interviews with dozens of sector colleagues from Canada and internationally in order to gather diverse definitions of, and perspectives on, localization. Colleagues included civil society, academia, non-profit and social enterprise, and private sector. The objective was to gain insight into how organizations talk about localization, understand the priorities and perspectives of partners, and identify potential future priorities for the coming decade. Interviews took place between July and October 2020 via videoconference, and lasted typically between 30-60 minutes. Potential respondents were identified by:

Some common interview prompting questions included, but were not limited to:

In addition, a literature review of dozens of grey literature content and publications was conducted to identify common trends and areas of inquiry. 

The resulting content from this investigation was extensive, and beyond what is feasible for inclusion in this report. Much has been written on the ‘why’ of localization, including: the ethical duty to support self determination of communities in issues affecting them; localization and the strengthening of local agency has been directly linked to improved learning; collaboration through compromise; improved accountability to and with stakeholders; buy-in and reputational legitimacy; and, much more. Therefore, we chose to focus on questions of ‘how’. As a coalition committed to supporting partnership, CanWaCH is particularly interested in focusing specifically on the responsibilities and requirements of Canadian development leaders; namely:


We recognize that municipal, regional, and national governments are also critical stakeholders in the conversation on localization. However, since we did not speak with representatives of these groups during this analysis, we are focusing instead on the perspectives of the respondents and the types of actors they represent.

For Canadian global health and development actors, localization is frequently conceived of as a spectrum along which progress is made towards the ultimate goal of autonomy and self-direction of local actors. As of 2020, it does not appear as though many Canadian actors have internal or systematic markers or measurements for talking about localization in their work and operations, or for tracking their progress along this spectrum. However, there is anecdotal interest in exploring this further.
COVID-19 and recent political and social movement has influenced sector-wide conversations about localization, creating a perceived sense of urgency among several Canadian and global actors to take concrete, measurable steps towards a localization agenda. This is seen as essential to ensuring relevance, results, and alignment with a rights-based approach.
Efforts towards localization in the coming decade will need to centre around shifting mindsets as much, if not more so, than processes or accountability measures. Working collaboratively, partners, funders, technical experts, researchers, and all other stakeholders will need to critically reflect on the assumptions and norms that have typically guided how we work as partners and how we track results, in order to realize the goals of localization.

None of the Canadian organizations who participated have a formal working definition of localization within their organization.

While all were familiar with the term and its history, and could provide a personal reflection on what localization looks like to them, there was consensus that organizations draw from commitments such as The Grand Bargain to shape their understanding of localization but do not have a specific definition of what this means for their work. Participants highlighted distinctions between different types of localization efforts. However, no distinct indicators or units of measurement were cited as being used to measure localization efforts in their programming or operations. Some organizations described leveraging a mix of human resource indicators and partnership descriptors (e.g. number of national staff in leadership roles, years in a partnership, etc.), but the examples given varied widely, and were all internal to an organization's own processes and language. Consistently, respondents indicated interest in sharing resources, tools, and best practice. As well, there were requests for clear and shared indicators and/or guidance on successful localization processes and partnerships.

Several respondents, when providing examples of localization within their organization, described a spectrum of possible ways in which localization could be realized, rather than a singular definition that would work in all contexts.

This was highlighted as being particularly relevant for distinctions between humanitarian, development, and unstable contexts, or for multi-sectoral initiatives. This spectrum could range from being locally informed (that is, local actors contribute to final decision-making but are not the sole decision-makers) to being locally led (where local partners have ultimate control and authority over decisions made). Outside of the parameters of this spectrum, one respondent described the alternatives to a localized approach: on one side, the local partner acts autonomously and global partners are not necessary, and on the other, local partners may appear to be in leadership roles but are functionally subject to ‘remote control’ by international partners. This can lead to, effectively, performative localization.

“Just because a local office is making plans, it doesn't automatically mean [the approach is] inclusive.”

Complicating these definitions are considerations of power and authority which typically accompany funding and international partnership. One Canadian organization described a ‘bargaining’ approach as fundamental to all partnerships in their organization, where national and international staff discuss decision-making throughout the partnership, but noted that this must be managed sensitively given the local perception of their organization as being very influential with global donors.

“Relationships take time, and they rely on people. This is the reason that, fundamentally, scrapping overhead and admin fees is never going to yield substantial results. Even if there is a formal [agreement] between organizations - and there should be - contracts do not replace human relationships.”
“We need more time to follow the processes that are required to build strong partnerships”

Some common features of an organizational commitment to localization that were shared include:

Tlanguage of localization is not new, and a commitment to working in partnership and solidarity with partners based in the countries and contexts where development happens is largely expected by today’s development actors. Indeed, as discussed earlier in this report, local leadership is integral to the conceptualization of the SDGs. Its return to the forefront of discussion may be inspired by COVID-19 and reflect restricted travel, social distancing, and virtual programming and monitoring processes. As funding is re-deployed to COVID-19 response efforts, governments and civil society will be looking to do more with fewer and less reliable financial resources than ever before. Maximizing resources can be achieved by instituting limited travel budgets, reducing office space, pooling resources with other organizations, and leveraging digital platforms.

It may also reflect a reckoning with the persistent realities of racism, colonialism, and inequalities in power, both in the world at large and within our sector, as well as the inspiring continued leadership (and resourcing) of local women’s rights groups and social justice advocates worldwide. Finally, with the increasing reflection on climate change and the importance of environmentally friendly approaches, reducing carbon emissions and strengthening communications and health infrastructure are now urgent priorities, and COVID-19 has shown clearly that a travel-conscious, technology-forward approach is reasonable and necessary.

Whatever the reasons, it is clear that this new decade has ushered in a clear call for change when it comes to understanding localization and making it happen. As international organizations cede physical space within countries, COVID-19 has presented an opportunity to...

"...see local development actors not only claiming the new space afforded them by setting the agenda but insisting more powerfully for greater ownership over humanitarian responses and development cooperation”.

It is a persistent challenge within development that complex global issues cannot typically be measured easily with broad indicators and frameworks.

During consultations, respondents noted that existing frameworks that are common across multiple international donors are often very complex, require extensive monitoring, and often focus more on ‘accounting’ than ‘impact’.

Multiple respondents observed that these frameworks risk effectively communicating to national partners that they are not trusted to deliver results without close scrutiny. While that may not be the intention of international organizations or donors, the result can be an erosion of trust between partners that is central to strong relationships. One respondent noted that for Canadian organizations who work as intermediaries between national organizations and donors, “It doesn’t matter that [the funder] is asking for time sheets. I’m relaying that request, so [the request] is seen as coming from me and my organization”. Respondents noted that predetermined indicators may measure what stakeholders in the global North want to know, but these may not align with priorities of national actors. This can shape not only work that is currently underway, but the sort of work that occurs in future. When combined with the power of multiple international funders all requesting the same sorts of accountability processes, the result...

“...means almost inevitably that proposals will come from ‘usual suspects’ who share a donor agenda; will be based on second-guessing what the donors are likely to support; and will not foreground a ‘searching’ approach, even if the organisation in question knows that this is the most likely to have an impact.”

“On one hand, funders say that they are flexible, and at the same time, they ask us to measure indicators that don’t match what the community wants”

To the question about the potential for increased risk of misappropriation of funds, corruption, and lack of impact if traditional accountability approaches are scrapped, perspectives varied. Here, respondents noted that many of the legal requirements for Canadian and international organization incorporation already provide the checks and balances needed to mitigate against major risks, and that additional restrictions fundamentally undermine localization. Other risks might be addressed more effectively by examining track records of results and establishing clear agreements with partners. Of course, doing so will likely further necessitate predictable, multi-year, ongoing funding that covers the general operational costs associated with partnership (namely, salaries and training).  

One recommendation included that, instead of putting restrictions on funding, partners should consider being more open to options. For instance, a global stakeholder looking to partner with a national organization might present recommendations for what they want to support, but ultimately allow local partners submitting proposals to determine which of the options they do or do not accept. During the time of COVID-19 for instance, some have described wanting to adopt the concept of a ‘No Regrets’ approach to funding, which could include: community health care; nutrition; health information systems; vaccine development; health research; distribution of medical supplies; protecting vulnerable groups; data and testing systems; and, cash finance for people in poverty.

This will not eliminate risk all together. In fact,[s]upporting local agency could allow [local] leaders to make bad policy decisions, and donors may think they could make better ones. In this case, the term ‘donors’ applies to all international stakeholders. However, partners at all levels will likely need to “[give] up the illusion of control and predictability” and instead focus on...

“...developing long-term and consistent relations with recipient organisations, including governments, which are pursuing a social change agenda that is compatible with the donor’s own values and mission.”

Strategies, including “iterative problem-solving, stepwise learning, brokering relationships, and discovering and negotiating common interests”, were shared as key ways of addressing these challenges. As Canadian organizations increasingly rely on national partners to plan, deliver, monitor, and report in contexts where they are no longer physically present, the norms by which we work begin to change. Frames such as ‘quality’, ‘rigorousness’, ‘legitimacy’, and ‘agency’ must also shift to reflect local perspectives.

Data collection and sense-making strategies
must privilege local knowledge and approaches.

Of course, this does not mean abandoning accountability altogether - far from it. The following considerations and provocative questions shared by partners on how to support localization were compiled and organized as structural, operational, and donor/funder recommendations. In many instances, an organization or institution may fulfill multiple roles. For the purposes of this report, we did not focus on recommendations for local/national partners in countries outside of Canada. 

Each of these reflections should be explored more fulsomely before implementation and their inclusion here does not constitute a recommendation to implement them as articulated here. However, we include them below to prompt dialogue and reflection in the months and years to come.

Organizational/Structural Level

Provocative Questions:

1. Does your organization have an articulated ‘exit strategy’ in certain countries or areas of work? If so, is this revisited regularly and available to local partners? Why or why not?

2. Does your organization have a definition of localization? Can you articulate what a spectrum of partnership, local leadership, and/or solidarity looks like to your agency?

3. How might/should your communications with Canadians change if you re-orient towards a focus on relationships and processes working with national actors?

Considerations:

Develop and articulate a clear theory of change for your organization’s overall mandate as well as individual project activities.
Foster relationships with local organizations that extend beyond or outside of specific projects. Include details of these relationships in proposals and communications materials.
Transition to 100% local staff, and require that senior leadership roles are held by locals. In the interim, look not only at the percentage of staff who are nationals, but at which roles are filled by national staff (directors/CEOs vs programmatic roles).
Pivot communications with donors and stakeholders to focus on relationships built and successes achieved over time, rather than specific outputs.
Engage with formal and informal communities of practice interested in exploring localization to strengthen learning.
Develop rubrics that ensure that local staff have sole decision-making authority over any hiring and partnering activities.

Operational/Programmatic

Provocative Questions:

1. How specifically have local staff designed the work? Have they designed the ultimate objectives
as well as the specific activities?

2. When you provide technical expertise, do you approach the experience as a ‘consultant’ where you provide recommendations for a local partner to approve or reject, or as a ‘contractor’ where you do the work yourself? Does this approach align with your understanding of localization?

3. Are we effectively supporting a ‘send the expert delegate’ model? How can we pivot to support
capacity building as a first choice, with international technical support as the secondary option?

Considerations:

Share data wherever feasible and safe to do so, obtain informed consent, and ensure that local partners know where and how to locate this information.
Share documents in word format (not pdf or locked files) so that they can be modified, shared, and used by others.
Articulate accountability plans to local partners and offices. Consider how to leverage digital platforms where appropriate so that access is ongoing.
Record decision-making processes and assigned authority in reports and reflect on this collectively with local partners at the end of the project.
In any community-facing activities, ensure that local partners are seen and reinforced in leadership and decision-making roles.
Keep international placements in field offices short and focused on specific deliverables.

Donor/Funder Relationships

Provocative Questions:

1. When assessing prospective partners, has adequate weight been given to the history of partnership between stakeholders?

2. How have historical context and local values shaped what constitutes performance in this project or partnership, and how is this being continually reassessed?

3. What level of risk and tolerance for ambiguity are we willing to accept, and can we challenge ourselves to increase this? What ‘accounting’ measures have been required of this project and can impact be assessed by other means?

Considerations:

Reorient funding calls to allow for greater flexibility in proposals, including being open to receive alternative programming suggestions by partners in different contexts.
Provide core funding, including capacity strengthening dollars and human resource costs.
Require the use of local capacity for all monitoring, evaluation, accountability, and learning activities.
Include considerations of local leadership, mutuality, connectivity, and financing plans in follow-up evaluations.
Create mechanisms by which you can receive feedback from local partners on accountability processes and funding priorities, mindful of the power imbalances that frequently preclude receiving candid feedback.
Review and revise accountability processes to allow for greater navigation by judgement by local partners.
Credit: Nandhu Kumar via Unsplash

Respondents seemed to agree that a general relaxing of measures of accountability would also free up significant time and resources on the side of Canadian organizations to be able to undertake more effective programming and partnership brokering, and also allow for a pivoting of their role towards a focus on capacity-strengthening and allyship. It was also recommended that stakeholders shift from a focus on deliverables to a focus on the process used.

“The perception of what constitutes ‘results’ needs to change”.

“Bureaucracy is rooted in a mindset of mistrust”

Among respondents, it was generally agreed that specific tactics for supporting localization need to follow a fundamental shift in mindset that moves beyond the rhetoric of an ‘us’ who keeps a ‘them’ accountable. Instead, an orientation towards mutual accountability, greater trust placed in the day-to-day, big-picture judgement of national actors, and acceptance of ambiguity and risk are essential.

“The question of corruption and fraud seems to be a major concern, usually in reference to local partners. But implicit in this [concern] is the fundamental assumption that local partners are inherently untrustworthy, and that’s the norm that has to be challenged”.

“It is a fallacy that if our [reporting] systems are strong enough, we won’t have corruption. All that happens is that we don’t have enough room to move”

Credit: Bill Wegener via Unsplash
Shifting towards localisation and away from externally-driven change inevitably means giving up control and relinquishing power. It also means admitting that many things in aid and development simply cannot be predicted. This requires us to recognise that the essence of [monitoring and evaluation] – that is, the ability to assess progress, learn and adapt – is not something external to social change, but rather is central to it.”

This reflection barely scratches the surface of a robust discussion that is already underway among Canadian global health and development leaders. However, it certainly inspires us to consider how CanWaCH can support further exploration of this topic, as well as the capacity of our sector to navigate these questions in the coming decade.

As part of CanWaCH’s ongoing interest in this topic, we will be taking three concrete actions:

As with all of our work, we welcome any feedback, engagement, and recommendations directly on this topic at impact@canwach.ca.

Credit: Annie Spratt via Unsplash

07

SECT. 7
Conclusion

2020 affords us all a moment to look backward and forward at two powerful decades in global health, humanitarian response, and international cooperation. The years between 2010-2020 have seen Canadians step into a global leadership role in advancing the health and rights of women, children, and youth. During this time, Canadian development actors warmly embraced the spirit and pursuit of the Sustainable Development Goals (SDGs), recognizing that these goals have both global and local implications and responsibilities. In the earlier sections of this report, the data tells a clear story: through our efforts, and those of our global partners, there are women, children, and youth who are surviving and thriving in ways that they may not have just a few years ago. All of this has been possible as a result of sustained programming, a focus on capacity-sharing and strengthening, and an innovation-ready mindset that encourages adaptation and agility. Within CanWaCH, whether it is through our Canadian Collaborative for Global Health Initiative, or through our working groups, consultations, and publications, we have spent the last few years witnessing firsthand the power of partnership in achieving and measuring results around the world. 

2020-2030 was long ago dubbed the Decade of Action. We knew going into this period that bold efforts would be needed. However, COVID-19 has brought about a fundamental re-imagining of our assumptions, plans, and norms of working. We have heard clearly in this report, that - as the saying goes - ‘what got you here won’t get you there’. Too many of our approaches are rooted in outdated norms, performative accountability, and implicit assumptions about the role of developing country partners as perpetual ‘learners’ and wealthy country partners as ‘experts’. Investments at the individual level cannot be our sole focus. We also urgently need to direct our attention towards the enabling environment of change: resourcing and strengthening global health and information systems; addressing inequity and supporting empowerment of marginalized voices; actively combating misinformation and promoting evidence-based decision-making; working across local, regional, national, and international channels; and, doing the essential work necessary to ensure, without question, that local actors lead. 

The future is always uncertain, and the crises of this year have made it abundantly clear that our sector must be flexible, innovative, and data-driven if we wish to see meaningful action in this decade. Based on the provocative insights and rich expertise collected and shared in this report, we have every confidence that the ability to lead effectively, mobilize evidence, and collaborate equitably is well within the hands of Canadian actors and their partners.

Acknowledgements

This report was developed by the Canadian Partnership for Women and Children’s Health (CanWaCH).
We gratefully acknowledge the contributions of Jessica Ferne, Talia Glickman, Antu Hossain, Imaeyen Okon,
Fallyn Thompson-Browes, and Mélody Tondeur. Thank you to Klaudia Rymaszewski and Tina LaRochelle for their support with literature review and data entry.

Microsite developed by Arq Design Studio, and powered by Webflow.

The insights and data referenced in this report have been provided by contributing organizations, and have not been independently verified by CanWaCH. Numbers are accurate at the time of publication, and may change as projects are updated. As such, the figures in this report may differ from current data shown on the website. CanWaCH does not endorse or recommend specific programs or activities, and the content of this report is intended to be inspirational and not prescriptive.  

The designations and maps in this report do not imply the expression of any opinion whatsoever on the part of CanWaCH concerning the legal status of any country, territory, city or area or its authorities, or concerning the delimitation of its frontiers or boundaries. 

We are grateful to the individuals from the following organizations and institutions who took the time to provide insights and resources that informed this report. We also acknowledge all additional organizations who contributed data to the Project Explorer during the past year. 

ACIC

ACTED

Action Against Hunger Canada

ADRA Canada

Aga Khan Foundation Canada

Alinea International

Amref Health Africa in Canada (AMREF)

AWID

Bruyère Research Institute

Campbell Collaboration

Canada Africa Partnership (CAP) Network

Canadian Association of Midwives

Canadian Coalition for Global Health Research (CCGHR)

Canadian Feed The Children (CTFC)

Canadian Red Cross

Canadian Society for International Health

CARE Canada

Carleton University

Carrefour de solidarité internationale

CAUSE Canada

CECI

Centre for International Cooperation in Health and Development (CCISD

Centre of Excellence for Women's Health

Centre for Global Health Research

Centre for International Child Health

Children Believe

Clinton Health Access Initiative

Council on Foundations

CowaterInternational

Crossroads International

Cuso International

Dalhousie University

Days for Girls Canada Society

Developmental Leadership Program

effect:hope

Femme International

Fondation Mères du Monde en Santé

Fondation Paul Gérin-Lajoie

Grand Challenges Canada

Health Partners International of Canada (HPIC)

HealthBridge Foundation of Canada

Helen Keller International (HKI)

Hope and Healing International

HOPE International Development Agency

Horizons of Friendship

Humanity and Inclusion

Inter Pares

Interagency Coalition on AIDS and Development (ICAD)

International Development Research Centre (IDRC)

International Planned Parenthood Federation (IPPF)

Ipas

Islamic Relief Canada

Johns Hopkins University

L'AMIE

McGill University

Médecins du Monde Canada

Memorial University of Newfoundland - Faculty of Medicine

Mennonite Central Committee Canada

Mission Inclusion

National Abortion Federation Canada

Nutritional International

Operation Eyesight Universal

Orbis Canada

Oxfam Canada

Oxfam Québec

Partners for Impact

Partners In Health Canada (PIH)

Pathfinder International

Plan International Canada

Population Services International

PRE-EMPT

Réseau francophone international pour la promotion de la santé (RÉFIPS)

Root Change

Salanga

Samaritan's Purse Canada

Save the Children Canada

Seva Canada Society

SickKids Centre for Global Child Health

Tearfund Canada

Teck

The Primate's World Relief and Development Fund (PWRDF)

The Salvation Army Canada

The Society of Obstetricians and Gynaecologists of Canada (SOGC)

Tula Foundation

UNICEF Canada

Unité de santé internationale - Université de Montréal

University of Calgary, Cumming School of Medicine

University of Manitoba Centre for Global Public Health

University of Ottawa

University of Saskatchewan

University of Toronto

WaterAid Canada

World Neighbours Canada

World Vision Canada

Comments or questions on this report may be directed to impact@canwach.ca

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